Petra De Sutter is a gynaecologist, and professor in reproductive medicine at Ghent University (Belgium) and also a politician. She is member of the Belgian Senate and the Parliamentary Assembly of the Council of Europe, where she is active in the committee of migration and in the committee of social affairs. She also is vice-chair of the European Parliamentary Forum on Population and Development.
Q: You have spent your career working in the general area of medical health as it pertains to motherhood. What, in your view, are the major issues threatening the motherhood experience?
A: I have been working in gynaecology my whole career, anything that has to do with early pregnancy/miscarriage is of interest to me, because a healthy pregnancy starts with healthy conception. I have been talking with the World Health Organisation, and unwanted children has become a hot topic, as there are too many children. Yet, in some areas of India and Africa, 25% are infertile, and the other 75 per cent have too many children. If we are talking about family planning we cannot ignore the 25% if you can’t have kids it destroys your life you are thrown out of the community in Africa, in India the same thing, if you can’t have a child you are not a woman, we need to work from both sides, we need to control fertility in the woman who have too many kids, inform them to have less children and also help those who can’t, matter of inequality matter of justice, we need to do everything to raise awareness of family planning, and also those who have no children by helping with fertility
You can not only think about preventing women having too many children but also about those who can’t have children. It has a lot to do with justice and women’s rights.
There is a difference between Europe and Africa/India, it has a lot to do with education, and gender equality. Migrants are vulnerable groups, and I am also very interested in issues related to LGBT. Women are vulnerable in these groups, women do not have access to healthcare, psychological and otherwise.
One of Safe Motherhood Week’s themes is that of information, or lack thereof, or even the ability to navigate the information that exists. Do you see this as a problem?
Barriers are a major thing because we have the best possible care, but not equal access. That is a major point of interest for Europe, but also outside Europe, there is the issue of gender equality, women being able to go to school, instead of being married at 12. This is maybe not a major thing in Europe but it is in other parts of the world.
We really need to educate people and tell them in schools the things they need to know about sexual reproduction and that will in turn lead to better healthcare and maternal healthcare, safe motherhood. It is ignorance, an ignorance that is reinforced by religion, which is damaging and is a big issue in Europe still, as i have seen from my work in the Council.
We need education for telling people how things are and how it can be managed – safe pregnancy starts before conception; things like smoking and other lifestyle issues that will affect foetal health, these need to be addressed before pregnancy. Once a woman is pregnant it is already too late, there are optimal conditions for pregnancy before pregnancy occurs. We need good education, we need awareness; good preparation for pregnancy is such a huge thing it should not be blocked by any ideological barriers.
At Safe Motherhood Week, we are seeking to address inequalities in care, which can often be based on background. Whether you are a migrant, maybe poor… poverty and ignorance will affect the standard of care, how can this be addressed?
There is a political responsibility here; Governments, lawmakers etc., should really focus on these vulnerable groups. Again, it’s just about education and reaching out to these groups, but what you often see is a lot of good initiatives in isolation.
I’ll give you an example: We started a preconception consultation in our own hospital, we wanted to educate woman to be healthier when they want to be pregnant, we did a lot of PR to make this known. But what we saw was that we only got very highly educated woman who were having problems conceiving, we had targeted the wrong demographic. This was not acceptable and we could not continue. We have to think about what the reasons are we did not reach the women we wanted to reach… if you want to reach migrant women, you have to go to their communities and listen to their stories and what their needs are, you have to tell them and educate them, talk their language. You just can’t open some consultation session somewhere, they will not come. We need to invest money to reach to their groups who do not have access, in reality they could have come because it was free, but we did not reach them because we did not go to them to seek them out, for them to understand how important it was.
Surveys on the internet are interesting but you will only target people that know how to work the internet… lots of people who aren’t educated enough to use the internet and these are the ones who we really need to reach by going to their communities. It is not easy but this should be our focus.
You have highlighted the issue of violence to migrant woman and you acknowledge that in addition their sexual and reproductive rights aren’t being addressed – you called them “double victims”. What is happening when it comes to migrant populations and maternal rights and what can be done to help?
When I visited the refugee camps in Greece recently, we discussed this issue with the parliament and minister for migration, he happens to be a gynaecologist also, so I directly sought him out.
I asked him, what are you doing for women who are arriving here because they don’t have access to contraception, they don’t have access to safe abortion, they are raped? He was embarrassed, [he said] “we don’t have the means… we have other priorities, such as food, shelter, this is something we will look at a later stage”.
I understood him, but these are exactly the situations where women are most vulnerable… you wait a couple of months in these camps, but from day one you have a responsibility to care for these women, you need to prioritise the woman because they are the most vulnerable. You cannot put security above their needs.
Sexual and domestic violence occurring in refugee camps tends to bring out the opinion of the general public, that we should send them all back. No one is thinking about why are they fighting and what conditions they are living in. It’s the same if men rape women there, they are just seen as barbarians and that the refugees need to go home.
To me it is clear that you have to go to these communities, and educate them, give them access to contraceptives, make sure no risk of prostitution networks, you need to take care of these things if you want to take responsibility, and it’s a moral issue for Governments and everyone involved.
Our theme for Safe Motherhood Week this year is that “Motherhood is our power to shape the future. It is everyone’s responsibility to make it safe.” What are your thoughts on this statement?
I think it’s an excellent slogan, it puts universal responsibly in the forefront. It’s about our children, the survival of humankind. It’s the future, our mothers, women who are pregnant, and who will take care of our children. We need to take responsibility in helping them and providing them with the best possible care, as a duty and responsibility to our future, that’s what I get from that slogan.
I think it’s perfect, it puts the emphasis on us, not just the individual… for example, a woman who smokes during pregnancy, we might say well it’s her own responsibility, of course not, we have to think about the child, which is our common future. We all have to make sure that women do not smoke – not by repression but by educating people and making sure they don’t smoke during pregnancy.
It’s the responsibly of everyone, also by people who are not personally involved with pregnancy. It’s so so important for public health in that respect, it’s an issue that should be addressed by Governments, and by politicians because it is about our health, our future generations, our communities.
Is there anything specifically relevant to Safe Motherhood Week, that you are working on that you want to highlight as part of this article any project or article that is directly related?
I have been involved in a motion for a resolution, which is a discussion on universal access in maternal healthcare. In the Council of Europe, we can work on motions in the parliamentary assembly and well anyone can take an initiative, the motion goes to the committee and we write a report on it. We refer in the motion to the Safe Motherhood Week survey that has been done in Europe, which showed how many women who were pregnant and felt they are victims of discrimination in the workplace. This is going to look at access to maternal healthcare and what are the barriers. I think it’s an interesting subject for them to tackle, as that resolution will also contain some recommendations that will go to the Council of Ministers, they have to do something with it, and bring this to their own local Governments.
Safe motherhood is a matter of human rights. In our fight for sexual and reproductive health and rights it is one of the most basic and important issues. Access to high quality pregnancy and childbirth care, prevention of maternal mortality and efficient postdelivery contraception are priorities at a global level, in view of the new sustainable development goals that were set last year. As a gynaecologist, a human rights activist and a politician, I want to call upon everyone to support the Safe Motherhood Week campaign!
Discover all our Safe Motherhood Week Luminaries here.
Find out more about Safe Motherhood Week this year!